Telemedicine technologies have become increasingly popular as a means of delivering general and specialist healthcare to individuals and communities situated in rural areas who have difficulties in accessing health-care services. The importance of interaction between patients and healthcare professionals has been consistently highlighted with previous research on face-to-face consultations demonstrating that interaction can impact on patients’understanding of medical information, their perception of their own disease and their quality of life (Onor & Misan, 2006; Miller, 2003). This is particularly relevant in speech language therapy, where conversation may already be challenging, and differing methods of communication maybe required. The introduction of telemedicine into health-care providerpatient interaction adds an additional dynamic in which these interactions occur. However, limited research has explored how conversations are negotiated when delivered via telemedicine, especially in challenging contexts such as speech and language therapy.The present study drew on 16 consultations (8 hours 58 minutes) using telemedicine technologies in speech and language therapy. The study drew on both audio and visual data examining naturally occurring interaction between a specialist speech language therapist, general speech language therapist and patient and was analysed using Conversation analysis. The analysis considers how medical tasks are achieved through extended request sequences during physical examinations when using telemedicine. The results demonstrate that extended request sequences were framed as a collaborative endeavour through the plural pronoun ‘we’ which treated participants as equal in the fulfilment of medical tasks. Participants manage the interactional novelties that occur with telemedicine such as lack of proximity and visual access during the fulfilment of extended requests. In so doing, the results demonstrate the integral roleof the general speech language therapist who not only facilitates request making when required, but also assists in the fulfilment of initial requests. Implications and directions for future research are considered regarding extended request sequences as a means of achieving medical tasks which overcome barriers such as lack of proximity and visual access, thus facilitating effective interpersonal interaction during telemedicine speech language therapy consultations.
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Thesis, 1.55 MB, PDF
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